Form 5500 · Employee benefit plan · ONTARIO, NY
OPTIMAX SYSTEMS, INC.
The filing calls this plan OPTIMAX SYSTEMS, INC. WELFARE BENEFIT PLAN.
OPTIMAX SYSTEMS, INC. of ONTARIO, NY insures dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is TITAN INSURANCE DBA USEBSG. Coverage is written through EXCELLUS BLUE CROSS BLUE SHIELD and 5 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 16-1399834 · plan 501 · plan year 2025, filed Jul 14, 2026
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3,536 other employer plans in New York have policy years ending in December. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
8 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 12 insured contracts covering dental, vision, life and disability; the largest, with EXCELLUS BLUE CROSS BLUE SHIELD, covers 288 people.
The filing declares health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on one of the 8 contracts here that do not say what they cover.
Reported premium across the insured contracts is $693,152, with $124,149 in disclosed broker commissions — about 18% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
TITAN INSURANCE DBA USEBSG is the broker of record on 1 of the 12 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| EXCELLUS BLUE CROSS BLUE SHIELD | — | 288 | Jan 1, 2026 | $299,299 | $98,645 |
| EXCELLUS BLUE CROSS BLUE SHIELD | Dental | 310 | Jan 1, 2026 | $193,579 | $9,202 |
| MUTUAL OF OMAHA INSURANCE COMPANY | — | 253 | Jan 1, 2026 | $72,655 | $4,566 |
| MUTUAL OF OMAHA INSURANCE COMPANY | Disability | 202 | Jan 1, 2026 | $36,542 | $3,327 |
| MUTUAL OF OMAHA | — | 117 | Jan 1, 2026 | $30,098 | $3,005 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | Vision | 238 | Jan 1, 2026 | $29,991 | $2,250 |
| COMPANION LIFE INSURANCE COMPANY | Life | 443 | Jan 1, 2026 | $16,843 | $1,684 |
| CONTINENTAL AMERICAN INSURANCE COMPANY | — | 7 | Jan 1, 2026 | $5,618 | $618 |
| MUTUAL OF OMAHA INSURANCE COMPANY | — | 443 | Jan 1, 2026 | $4,882 | $488 |
| MUTUAL OF OMAHA INSURANCE COMPANY | — | 0 | Jan 1, 2026 | $2,278 | $228 |
| MUTUAL OF OMAHA INSURANCE COMPANY | — | 0 | Jan 1, 2026 | $1,074 | $107 |
| MUTUAL OF OMAHA INSURANCE COMPANY | — | 0 | Jan 1, 2026 | $293 | $29 |
Premium and claims on this contract
EXCELLUS BLUE CROSS BLUE SHIELD, contract 55269. For the contract year on this filing, the carrier reported $193,579 in premium earned and $152,787 in claims incurred. Dividing one by the other gives 79%.
- EXCELLUS BLUE CROSS BLUE SHIELD, contract 55269 reported $45,698 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 430 employees, 8 recordable cases, 3 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
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